Clinical significance of melatonin concentrations in predicting the severity of acute pancreatitis

Yin, Jia; Cui, Lin; Dong, Lemei; Chen, Meng-Jun; Zhou, Qiong; Wu, Jiang

doi:10.3748/wjg.v19.i25.4066

Cited by 18 publications

(21 citation statements)

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“…Variation in the level of melatonin can be used as a marker for prediction of SAP. Melatonin concentration below 28.74 ng/L has been found to be associated with severe acute pancreatitis as found by Jin et al [ 101 ].…”

Section: Emerging Potential Biomarkers For Prediction Of Severity mentioning

confidence: 87%

Role of Biomarkers in Diagnosis and Prognostic Evaluation of Acute Pancreatitis

Meher

Mishra

Sasmal

et al. 2015

Journal of Biomarkers

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Acute pancreatitis is a potentially life threatening disease. The spectrum of severity of the illness ranges from mild self-limiting disease to a highly fatal severe necrotizing pancreatitis. Despite intensive research and improved patient care, overall mortality still remains high, reaching up to 30–40% in cases with infected pancreatic necrosis. Although little is known about the exact pathogenesis, it has been widely accepted that premature activation of digestive enzymes within the pancreatic acinar cell is the trigger that leads to autodigestion of pancreatic tissue which is followed by infiltration and activation of leukocytes. Extensive research has been done over the past few decades regarding their role in diagnosis and prognostic evaluation of severe acute pancreatitis. Although many standalone biochemical markers have been studied for early assessment of severity, C-reactive protein still remains the most frequently used along with Interleukin-6. In this review we have discussed briefly the pathogenesis and the role of different biochemical markers in the diagnosis and severity evaluation in acute pancreatitis.

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Section: Emerging Potential Biomarkers For Prediction Of Severity mentioning

confidence: 87%

Role of Biomarkers in Diagnosis and Prognostic Evaluation of Acute Pancreatitis

Meher

Mishra

Sasmal

et al. 2015

Journal of Biomarkers

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“…The possible implication of melatonin in the innate defense of the pancreas against acute inflammation was supported by clinical observations, showing that in patients with acute pancreatitis, high melatonin blood concentration observed in the first 24 h after the onset of pancreatic inflammation was correlated with a mild course and optimistic prognosis for patients, whereas severe pancreatitis was accompanied with low melatonin blood level [ 85 , 86 ].…”

Section: Melatonin System and Acute Pancreatitismentioning

confidence: 99%

Effects of Melatonin and Its Analogues on Pancreatic Inflammation, Enzyme Secretion, and Tumorigenesis

Jaworek

Leja-Szpak

Nawrot-Porąbka

et al. 2017

IJMS

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Melatonin is an indoleamine produced from the amino acid l-tryptophan, whereas metabolites of melatonin are known as kynuramines. One of the best-known kynuramines is N1-acetyl-N1-formyl-5-methoxykynuramine (AFMK). Melatonin has attracted scientific attention as a potent antioxidant and protector of tissue against oxidative stress. l-Tryptophan and kynuramines share common beneficial features with melatonin. Melatonin was originally discovered as a pineal product, has been detected in the gastrointestinal tract, and its receptors have been identified in the pancreas. The role of melatonin in the pancreatic gland is not explained, however several arguments support the opinion that melatonin is probably implicated in the physiology and pathophysiology of the pancreas. (1) Melatonin stimulates pancreatic enzyme secretion through the activation of entero-pancreatic reflex and cholecystokinin (CCK) release. l-Tryptophan and AFMK are less effective than melatonin in the stimulation of pancreatic exocrine function; (2) Melatonin is a successful pancreatic protector, which prevents the pancreas from developing of acute pancreatitis and reduces pancreatic damage. This effect is related to its direct and indirect antioxidant action, to the strengthening of immune defense, and to the modulation of apoptosis. Like melatonin, its precursor and AFMK are able to mimic its protective effect, and it is commonly accepted that all these substances create an antioxidant cascade to intensify the pancreatic protection and acinar cells viability; (3) In pancreatic cancer cells, melatonin and AFMK activated a signal transduction pathway for apoptosis and stimulated heat shock proteins. The role of melatonin and AFMK in pancreatic tumorigenesis remains to be elucidated.

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“…It has been postulated that melatonin might play a protective role in AP. Jin et al studied the capability of melatonin to predict the severity of AP in a single-center trial including 55 patients 88 . MAP patients were found to have higher melatonin levels than SAP patients on the first day after admission.…”

Section: Melatoninmentioning

confidence: 99%

Laboratory markers predicting severity of acute pancreatitis

Staubli¹,

Oertli²,

Nebiker³

2015

Critical Reviews in Clinical Laboratory Sciences

181

122

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Acute pancreatitis (AP) is an inflammatory disease of highly variable severity, ranging from mild cases with low mortality to severe cases with high mortality. Numerous biomarkers have been studied as potential early predictors of the severity of this disease so that treatment can be optimally tailored to prevent complications. We aim to present and discuss the most relevant biomarkers for early severity assessment in AP that have been studied to date. We review the current literature on biomarkers that have been used to predict the severity in AP. C-reactive protein (CRP) is still considered to be the gold standard, with a cut-off value of 150 mg/ml 48 h after disease onset. Other markers, including procalcitonin (PCT) and interleukin 6 (IL-6) have been implemented in some hospitals, but are not used on a routine basis. Most other markers, including acute phase proteins (LBP, SAA, PTX3), cytokines (Il-8, TNF-a, MIF), activation peptides of pancreatic proteases (TAP, CAPAP, PLAP), antiproteases (AAT, a2M), adhesion molecules (ICAM-1, selectins, E-cadherin) and leukocyte-derived enzymes (PA2, PMN-E) have shown some promising results but have not been routinely implemented. Furthermore, new and interesting biomarkers (Copeptin, TRX-1, Ang-2, E-2) have shown good results, but more research is needed to determine if they could play a role in the future. Various reasons why new markers for disease severity have not been adopted in daily routine include low accuracy, cumbersome laboratory techniques and high cost. Despite these difficulties, research is still very active in finding new markers to predict the severity of AP.

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Clinical significance of melatonin concentrations in predicting the severity of acute pancreatitis

Abstract: The melatonin concentration is closely related to the severity of AP and the BISAP score. Therefore, we can evaluate the severity of disease by measuring the levels of serum melatonin.

Cited by 18 publications

References 0 publications

Role of Biomarkers in Diagnosis and Prognostic Evaluation of Acute Pancreatitis

Role of Biomarkers in Diagnosis and Prognostic Evaluation of Acute Pancreatitis

Effects of Melatonin and Its Analogues on Pancreatic Inflammation, Enzyme Secretion, and Tumorigenesis

Laboratory markers predicting severity of acute pancreatitis

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